Vision Information for Families

Preschool Age ScreeningLEA Symbols | Stereo Image | Observation Preschool vision screening begins with a specific conditioning process. Children begin by practicing as a group, in response to the images presented by the vision technician. Once the technician is confident in the students' responses, they are then screened individually. Students with corrective lenses are screened with lenses in place, provided they are available at the time of screening. Children stand at a 10-foot distance from the images being presented, and begin identifying a set of 20/40 images using both eyes. The child then uses a disposable occluder and identifies the same images, presented in random order, using each eye independently. If successful at the 20/40 level, each of the child's eyes is then screened at the 20/25 level. Once the acuity screening is complete, the child is then asked to identify an image presented as a stereo graphic. The stereo screening is used to identify potential eye muscle concerns. In addition to the visual acuity and muscle screening, the technician looks for a range of various observable ocular symptoms.

Once the initial screening is complete, the technician then reviews the results of each of the screening criteria to determine the need for rescreening. If no rescreen is necessary, the screening process is complete. In the event of a rescreen, the technician repeats the screening process, only for criteria with a questionable result. If the rescreen falls within MDHHS guidelines, the screening process is complete. Should the results continue to indicate a potential vision concern, a referral for further evaluation is initiated.

School Age ScreeningSnellen E | Phoria | ObservationSchool age vision screening is routinely offered for students in grades 1, 3, 5, 7, and 9. Students begin by reviewing examples of what they can expect to see inside the screening instrument. Once the technician is confident in the students' responses, they are then screened individually. Students with corrective lenses are screened with lenses in place, provided they are available at the time of screening. Students are positioned in front of the screener and place their forehead against the padded rest. They are first presented with simple images which aid in the identification of potential eye muscle concerns. Next, the technician sets the screener to occlude the left eye, and screens the visual acuity of the right eye at 20/20. Occlusion is then reversed, and the left eye is screened. Acuity levels are increased to 20/30 and 20/50 as necessary. Students are then screened for the effects of a plus lens placed within the line of sight. In addition to the muscle screening, visual acuity, and plus lens test, the technician looks for a range of various observable ocular symptoms.

Once the initial screening is complete, the technician then reviews the results of each of the screening criteria to determine the need for rescreening. If no rescreen is necessary, the screening process is complete. In the event of a rescreen, the technician repeats the screening process, only for criteria with a questionable result. If the rescreen falls within MDHHS guidelines, the screening process is complete. Should the results continue to indicate a potential vision concern, a referral for further evaluation is initiated.

Any child with final screening results outside of MDHHS guidelines is referred for evaluation by a specialist. Families receive a copy of the screening results along with a letter recommending follow up with an eye care specialist. The referral also includes a list of area vision resources, an explanation of the screening criteria, and a form for providers to document their examination and share their findings with the Health Department to complete the child's record.

Follow Up Letter

Records that are not updated with documentation of follow up are issued a second letter requesting assistance in updating the child's file. Please know that the Health Department is required by the MDHHS to follow up with each child who is referred to a specialist. Prompt return of the 'Eye Care Specialist Report' will help to prevent additional contacts for follow up.

Post Referral Screenings

Students who are referred for further evaluation, but do not have documented follow up, are scheduled to be screened again the following school year. The screening process remains the same, however, those with continued vision concerns may be referred for further intervention and follow up care.